EAACI position paper on diet diversity in pregnancy,infancy and childhood: Novel concepts and implications for studies in allergy and asthma

To fully understand the role of diet diversity on allergy outcomes and to set standards for conducting research in this field, the European Academy of Allergy and Clinical Immunology Task Force on Diet and Immunomodulation has systematically explored the association between diet diversity and allergy outcomes. In addition, a detailed narrative review of information on diet quality and diet patterns as they pertain to allergic outcomes is presented. Overall, we recommend that infants of any risk category for allergic disease should have a diverse diet, given no evidence of harm and some potential association of benefit in the prevention of particular allergic outcomes. In order to harmonize methods for future data collection and reporting, the task force members propose relevant definitions and important factors for consideration, when measuring diet diversity in the context of allergy. Consensus was achieved on practice points through the Delphi method. It is hoped that the definitions and considerations described herein will also enable better comparison of future studies and improve mechanistic studies and pathway analysis to understand how diet diversity modulates allergic outcomes.     

EAACI Food Allergy and Anaphylaxis Guidelines: diagnosis and management of food allergy

Food allergy can result in considerable morbidity, impact negatively on quality of life, and prove costly in terms of medical care. These guidelines have been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Guidelines for Food Allergy and Anaphylaxis Group, building on previous EAACI position papers on adverse reaction to foods and three recent systematic reviews on the epidemiology, diagnosis, and management of food allergy, and provide evidence‐based recommendations for the diagnosis and management of food allergy. While the primary audience is allergists, this document is relevant for all other healthcare professionals, including primary care physicians, and pediatric and adult specialists, dieticians, pharmacists and paramedics. Our current understanding of the manifestations of food allergy, the role of diagnostic tests, and the effective management of patients of all ages with food allergy is presented. The acute management of non‐life‐threatening reactions is covered in these guidelines, but for guidance on the emergency management of anaphylaxis, readers are referred to the related EAACI Anaphylaxis Guidelines.     

SARS-CoV-2 Reverse Zoonoses to Pumas and Lions,South Africa

Reverse-zoonotic infections of severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) from humans to wildlife species internationally raise concern over the emergence of new variants in animals. A better understanding of the transmission dynamics and pathogenesis in susceptible species will mitigate the risk to humans and wildlife occurring in Africa. Here we report infection of an exotic puma (July 2020) and three African lions (July 2021) in the same private zoo in Johannesburg, South Africa. One Health genomic surveillance identified transmission of a Delta variant from a zookeeper to the three lions, similar to those circulating in humans in South Africa. One lion developed pneumonia while the other cases had mild infection. Both the puma and lions remained positive for SARS-CoV-2 RNA for up to 7 weeks.     

Hypoglycaemic activity of four plant extracts traditionally used in South Africa for diabetes

Aim

To validate plant species for hypoglycaemic activity.

Materials and methods

Four plants were investigated for hypoglycaemic activity by evaluating inhibiting effects on carbohydrate-hydrolising enzymes: α-glucosidase and α-amylase. Acetone plant extracts were screened against C2C12 myocytes, 3T3-L1 preadipocytes and Chang liver cells by measuring glucose uptake. Cytotoxicity was done in preadipocytes and hepatocytes.

Results

Extract of Euclea undulata rootbark exhibited highest activity, displaying a glucose uptake of 162.2% by Chang liver cells at 50 μg/ml. An inhibition concentration of 50% for Euclea undulata was found to be 49.95 μg/ml for α-glucosidase and 2.8 μg/ml for α-amylase. No cytotoxicity was recorded for Euclea undulata, while Schkuhria pinnata and Elaeodendron transvaalense exhibited cytotoxicity at 12.5 μg/ml. α-Glucosidase and α-amylase assays showed inhibitory activity on enzymes for three plant extracts.

Conclusion

Euclea undulata, Schkuhria pinnata and Elaeodendron transvaalense showed in vitro hypoglycaemic activity. Schkuhria pinnata and Elaeodendron transvaalense indicated cytotoxicity on 3T3-L1 preadipocytes and Chang liver cells. Euclea undulata, Pteronia divaricata and Elaeodendron transvaalense inhibited α-glucosidase and α-amylase enzymes.

Ethnopharmacological relevance

Screening of plant extracts scientifically validated traditional use of Euclea undulata for treatment of diabetes. Cytotoxicity results revealed that acetone extracts of Schkuhria pinnata and Elaeodendron transvaalense are toxic and raise concern for chronic use.     

Experimental pullout testing and comparison of variables in transpedicular screw fixation. A biomechanical study

The specific objective of this investigation was to assess and compare the relative performance of four types of pedicular fixation screws currently in use. All screws were tested under similar conditions. The results obtained have permitted the authors to rank the various screws tested in terms of performance as follows: 1) the Steffee screw, 2) the AO screw, 3) the Howmedica screw, and 4) the Roy-Camille screw. While the considerable variability of the bone material is recognized, the screw performance is also influenced by the geometric variables of screw design; improvements in the pullout strength can be achieved by an increase in the major diameter of the screw; screw displacement before failure appears related to the screw pitch, where an increase in the pitch of the screw will increase the amount of displacement before failure; screw angulation was found to have little effect on the pullout strength, but may have an effect on the screw displacement and energy absorption before failure.     

Is There a Fundamental 300 Hz Limit to Pulse Rate Discrimination in Cochlear Implants?

Literature often refers to a 300 pps limit for cochlear implant (CI) electrical stimulation, above which pulse rate discrimination deteriorates or above which rate pitch is not perceived to increase. The present study investigated the effect on pulse rate difference limens (PRDLs) when using compound stimuli in which identical pulse trains were applied to multiple electrodes across the length of the electrode array and compared the results to those of single-electrode stimuli. PRDLs of seven CI users were determined in two stimulus pulse phase conditions, one in which the phase delays between pulses on different electrodes were minimised (burst mode) and a second in which they were maximised (spread mode). PRDLs were measured at base rates of 100 to 600 pps in 100 pps intervals, using compound stimuli on one, two, five, nine and 18 electrodes. As smaller PRDLs were expected to reflect improved rate pitch perception, 18-electrode spread mode stimuli were also included in a pitch ranking task. PRDLs improved markedly when multi-electrode compound stimuli were used, with average spread mode PRDLs across listeners between 6 and 8 % of the base rate in the whole range tested (i.e. up to 600 pps). PRDLs continued to improve as more electrodes were included, up to at least nine electrodes in the compound stimulus. Stimulus pulse phase had a significant influence on the results, with PRDLs being smaller in spread mode. Results indicate that pulse rate discrimination may be manipulated with stimulus parameter choice so that previously observed deterioration of PRDLs at 300 pps probably does not reflect a fundamental limitation to rate discrimination. However, rate pitch perception did not improve in the conditions that resulted in smaller PRDLs. This may indicate that listeners used cues other than pitch to perform the rate discrimination task or may reflect limitations in the electrically evoked neural excitation patterns presented to a rate pitch extraction mechanism.     

Early bactericidal activity of paromomycin (aminosidine) in patients with smear-positive pulmonary tuberculosis

The early bactericidal activity of the aminoglycoside paromomycin (aminosidine) in doses of 7.5 and 15 mg/kg of body weight was measured in 22 patients with previously untreated smear-positive pulmonary tuberculosis. The fall in log(10) CFU per milliliter of sputum per day during the first 2 days of treatment for 7 patients receiving a paromomycin dosage of 7.5 mg/kg/day was 0.066, with a standard deviation (SD) of 0.216 and confidence limits from -0.134 to 0.266, and that for 15 patients receiving 15 mg/kg/day was 0.0924, with an SD of 0.140 and confidence limits from 0.015 to 0.170. The difference between the mean and zero was not significant for the 7. 5-mg/kg dose group but was significant for the 15-mg/kg dose group (t = 2.55, P = 0.023). Since paromomycin has no cross-resistance with streptomycin and has no greater toxicity than other aminoglycosides, these results suggest that it has the potential to substitute for streptomycin in antituberculosis regimens and may be a particularly valuable addition to the drug armamentarium for the management of multidrug-resistant tuberculosis.     

A Follow-Up Study of High-Functioning Autistic Children

Fifty-eight high-functioning autistic children were assessed during preschool and early school years and followed over a period of 8 years. Early and current psychometric and language tests, parent interviews concerning autistic symptomatology, and direct observations were examined as predictors of the Vineland Adaptive Behavior Scales and scores on standardized achievement tests. Verbal skills emerged as the strongest predictor of social-adaptive functioning. Clear, positive relationships also emerged between intellectual functioning, and academic attainment. Early non-verbal IQ also showed a positive relationship with outcome. Academic performance appeared considerably stronger than in earlier studies.